Pituitary apoplexy in a pregnant woman with cystic microprolactinoma

Ripoll, Roser Querol; Gómez, Rosa Cámara; García, Maribel del Olmo; Julián, Juan Antonio Simal; Torres, Juan Francisco Merino

doi:10.1016/j.endoen.2015.04.007

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…In seriously ill patients, the current literature and expert opinion favors surgical decompression. Analysis of 22 cases from Table II showed that surgical decompression in pregnancy is safe without any teratogenic effects (4,9,(17)(18)(19)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)51). The majority of cases were able to deliver in the late 3rd trimester as was exemplified by Oguz et al and Querol Ripoll et al; the authors showed that surgery performed even in the second trimester does not alter pregnancy course (17,34).…”

Section: Discussionmentioning

confidence: 97%

“…Analysis of 22 cases from Table II showed that surgical decompression in pregnancy is safe without any teratogenic effects (4,9,(17)(18)(19)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)51). The majority of cases were able to deliver in the late 3rd trimester as was exemplified by Oguz et al and Querol Ripoll et al; the authors showed that surgery performed even in the second trimester does not alter pregnancy course (17,34). Analysis of cases treated conservatively showed that this is a viable and safe option in a patient without visual field defects.…”

Section: Discussionmentioning

confidence: 99%

“…For 11 cases, long-time consequences were not noted. Most patients, while they were receiving multiple medications, reported a good quality of life (9,10,16,18,(31)(32)(33)(34)(43)(44)(45).…”

Section: Discussionmentioning

confidence: 99%

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Pituitary adenoma apoplexy in pregnancy: Case report and literature review

Pop¹,

Ilian

Georgescu

et al. 2022

Exp Ther Med

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Gestational pituitary apoplexy is an extremely rare condition. It is characterised by an unexpected headache, vomiting, nausea, and visual disturbances. Pituitary apoplexy in pregnancy and postpartum is a challenging diagnosis with symptoms overlapping multiple conditions. There is a limited number of articles presenting cases or case series of gestational pituitary apoplexy. This is a potentially life-threatening emergency which requires a high index of suspicion for its diagnosis. This article presents a case of postpartum pituitary apoplexy and outlines the current stage of clinical, imagistic diagnosis and management options. A 26-year-old primipara was submitted to a Caesarean section, with no perioperative incidents. Forty-eight hours later she reported the apparition of frontal and temporal throbbing headaches, nausea, photophobia, and she was diagnosed with a pituitary tumor measuring 33x10.5x15.5 mm. Although initially conservative treatment was proposed, the clinical outcome was not favourable, thus the patient was submitted to endoscopic transsphenoidal resection. The histopathological studies demonstrated the presence of a pituitary macroadenoma. At the 2-year follow-up, the patient is free of disease. Although it represents an extremely rare condition, gestational pituitary apoplexy should be suspected whenever headache and neurological disorders such as nausea and photophobia are reported during the postpartum period.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pituitary adenoma apoplexy in pregnancy: Case report and literature review

Pop¹,

Ilian

Georgescu

et al. 2022

Exp Ther Med

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Prolactinomas in pregnancy: considerations before conception and during pregnancy

Glezer

Bronstein

2019

Pituitary

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ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy

Luger

Broersen

Biermasz

et al. 2021

European Journal of Endocrinology

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Pregnancies are rare in women with pituitary adenomas, which may relate to hormone excess from secretory subtypes such as prolactinomas or corticotroph adenomas. Decreased fertility may also result from pituitary hormone deficiencies due to compression of the gland by large tumours and/or surgical or radiation treatment of the lesion. Counselling premenopausal women with pituitary adenomas about their chance of conceiving spontaneously or with assisted reproductive technology, and the optimal pre-conception treatment, should start at the time of initial diagnosis. The normal physiological changes during pregnancy need to be considered when interpreting endocrine tests in women with pituitary adenomas. Dose adjustments in hormone substitution therapies may be needed across the trimesters. When medical therapy is used for pituitary hormone excess, consideration should be given to the known efficacy and safety data specific to pregnant women for each therapeutic option. In healthy women, pituitary gland size increases during pregnancy. Since some pituitary adenomas also enlarge during pregnancy, there is a risk of visual impairment, especially in women with macroadenomas or tumours near the optic chiasm. Pituitary apoplexy represents a rare acute complication of adenomas requiring surveillance, with surgical intervention needed in some cases. This guideline describes the choice and timing of diagnostic tests and treatments from the pre-conception stage until after delivery, taking into account adenoma size, location and endocrine activity. In most cases, pregnant women with pituitary adenomas should be managed by a multidisciplinary team in a centre specialised in the treatment of such tumours.

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Pituitary apoplexy in a pregnant woman with cystic microprolactinoma

Cited by 3 publications

References 9 publications

Pituitary adenoma apoplexy in pregnancy: Case report and literature review

Pituitary adenoma apoplexy in pregnancy: Case report and literature review

Prolactinomas in pregnancy: considerations before conception and during pregnancy

ESE Clinical Practice Guideline on functioning and nonfunctioning pituitary adenomas in pregnancy

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